Individual
PATRICK GEORGE THORBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED ; BCBA
Contact information
Practice address
3800 CAMP CREEK PKWY SW BLDG 1400, ATLANTA, GA 30331-6247
(770) 999-9271
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(317) 516-6489
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38615
GA
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-19-38615
BCBA CERTIFICATE
GA
Enumeration date
02/02/2016
Last updated
03/04/2020
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